Covid-19 Health Declaration
Please complete our coronavirus (covid-19) health declaration within the 2 days prior to attending a course or first session each week.
By completing this coronavirus (covid-19) health declaration, you agree that we can give this basic information listed below, should the Ministry of Health require it for contract tracing purposes.
Should you develop any symptoms at anytime during or after your course or session, please contact us at email@example.com as we will need to inform the Ministry of Health for contact tracing.
If you have any of the following symptoms: fever (above 100.4 °F (38°C) ), tiredness, and dry cough then we advise you based on government guidelines to stay at home and you will be refused entry to the centre. Please see our ‘Coronavirus- Covid 19 section under our terms and conditions’ where you will be able to receive a credit for a future booking.
If you have recently travelled or been in close contact of a traveler (within 1m with no mask or face covering), you must follow the necessary travelers quarantine guidelines. Please check our Coronavirus (covid-19) section to view when you are allowed to attend the centre depending on your activity.
Please complete the following questions:
1) Are you currently suffering from any symptoms (fever (above 100.4 °F (38°C) , tiredness, and dry cough) of Coronavirus (covid-19) within the last 7 days of the course start date?
2) Have you had any of your household members feel symptoms of fever (above 100.4 °F (38°C), tiredness, loss of taste and dry cough in the last 14 days?
3) Have you been in close contact (In an enclosed space with no mask and no social distancing) with someone who has recently travelled under quarantine or a traveler before their day 4 negative test?
Please sign below:
Click to Sign
Signature of Partcipant
Parent/Guardians' Signature (If participant is under 18):
Click to Sign
Signature of parent/guardian (if under 18)
Current Date Wed Oct 20, 2021